Antibodies that bind Notum Pectinacetylesterase
Antibodies that neutralize Notum Pectinacetylesterase are described, as well as compositions comprising them, and methods of their use to treat diseases and disorders affecting the bone.
1. A method of stimulating endocortical bone formation in a patient in need thereof, comprising administering an effective amount of a pharmaceutical composition comprising a monoclonal antibody that binds to human notum pectinacetylesterase (NOTUM) and neutralizes at least one activity of NOTUM, wherein the antibody binds to a region of NOTUM from amino acids 47 to 177 of SEQ ID NO: 1, and wherein the antibody reduces NOTUM activity in a trisodium 8-octanoyloxypyrene-1,3,6-trisulfonate (OPTS) assay in vitro and reduces NOTUM activity in a Wnt signaling assay in vitro, wherein the antibody comprises a heavy chain variable region and a light chain variable region, wherein:
a) the heavy chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 17, a CDR2 having the amino acid sequence of SEQ ID NO: 18, and a CDR3 having the amino acid sequence of SEQ ID NO: 19, and the light chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 20, a CDR2 having the amino acid sequence of SEQ ID NO: 21, and a CDR3 having the amino acid sequence of SEQ ID NO: 22;
b) the heavy chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 25, a CDR2 having the amino acid sequence of SEQ ID NO: 26, and a CDR3 having the amino acid sequence of SEQ ID NO: 27, and wherein the light chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 28, a CDR2 having the amino acid sequence of SEQ ID NO: 29, and a CDR3 having the amino acid sequence of SEQ ID NO: 30;
c) the heavy chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 33, a CDR2 having the amino acid sequence of SEQ ID NO: 34, and a CDR3 having the amino acid sequence of SEQ ID NO: 35, and the light chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 36, a CDR2 having the amino acid sequence of SEQ ID NO: 37, and a CDR3 having the amino acid sequence of SEQ ID NO: 38; or
d) the heavy chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 57, a CDR2 having the amino acid sequence of SEQ ID NO: 58, and a CDR3 having the amino acid sequence of SEQ ID NO: 59, and wherein the light chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 60, a CDR2 having the amino acid sequence of SEQ ID NO: 61, and a CDR3 having the amino acid sequence of SEQ ID NO: 62.
2. The method of claim 1 , wherein the antibody increases serum Procollagen I N-terminal Propeptide (PINP) levels in vivo, increases bone mineral density in vivo, increases midshaft femur cortical thickness in vivo, increases midshaft femur bone area in vivo, increases midshaft humerus cortical thickness in vivo, increases endocortical bone formation in vivo, increases the proportion of cortical bone volume in the LV5 vertebral body in vivo, and/or increases the proportion of femoral neck bone volume to femoral neck total volume in vivo.
3. The method of claim 1 , wherein the antibody is selected from a chimeric antibody, a humanized antibody, and a human antibody.
4. The antibody of claim 1 , wherein the heavy chain variable region comprises an amino acid sequence selected from SEQ ID NOs: 15, 23, 31, 55, 63, 71, 75, and 79.
5. The antibody of claim 1 , wherein the light chain variable region comprises an amino acid sequence selected from SEQ ID NOs: 16, 24, 32, 56, 65, 73, 77, and 81.
6. The antibody of claim 1 , wherein:
a) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 15 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 16;
b) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 71 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 73;
c) the heavy chain comprises the amino acid sequence of SEQ ID NO: 72 and the light chain comprises the amino acid sequence of SEQ ID NO: 74;
d) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 23 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 24;
e) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 75 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 77;
f) the heavy chain comprises the amino acid sequence of SEQ ID NO: 76 and the light chain comprises the amino acid sequence of SEQ ID NO: 78;
g) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 31 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 32;
h) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 79 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 81;
i) the heavy chain comprises the amino acid sequence of SEQ ID NO: 80 and the light chain comprises the amino acid sequence of SEQ ID NO: 82;
j) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 55 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 56;
k) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 63 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 65; or
l) the heavy chain comprises the amino acid sequence of SEQ ID NO: 64 and the light chain comprises the amino acid sequence of SEQ ID NO: 66.
7. A method of treating, managing, or preventing a disease or disorder characterized by bone loss in a patient, comprising administering an effective amount of a pharmaceutical composition comprising a monoclonal antibody that binds to human notum pectinacetylesterase (NOTUM) and neutralizes at least one activity of NOTUM, wherein the antibody binds to a region of NOTUM from amino acids 47 to 177 of SEQ ID NO: 1, and wherein the antibody reduces NOTUM activity in a trisodium 8-octanoyloxypyrene-1,3,6-trisulfonate (OPTS) assay in vitro and reduces NOTUM activity in a Wnt signaling assay in vitro, wherein the antibody comprises a heavy chain variable region and a light chain variable region, wherein:
a) the heavy chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 17, a CDR2 having the amino acid sequence of SEQ ID NO: 18, and a CDR3 having the amino acid sequence of SEQ ID NO: 19, and the light chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 20, a CDR2 having the amino acid sequence of SEQ ID NO: 21, and a CDR3 having the amino acid sequence of SEQ ID NO: 22;
b) the heavy chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 25, a CDR2 having the amino acid sequence of SEQ ID NO: 26, and a CDR3 having the amino acid sequence of SEQ ID NO: 27, and wherein the light chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 28, a CDR2 having the amino acid sequence of SEQ ID NO: 29, and a CDR3 having the amino acid sequence of SEQ ID NO: 30;
c) the heavy chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 33, a CDR2 having the amino acid sequence of SEQ ID NO: 34, and a CDR3 having the amino acid sequence of SEQ ID NO: 35, and the light chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 36, a CDR2 having the amino acid sequence of SEQ ID NO: 37, and a CDR3 having the amino acid sequence of SEQ ID NO: 38; or
d) the heavy chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 57, a CDR2 having the amino acid sequence of SEQ ID NO: 58, and a CDR3 having the amino acid sequence of SEQ ID NO: 59, and wherein the light chain variable region comprises a CDR1 having the amino acid sequence of SEQ ID NO: 60, a CDR2 having the amino acid sequence of SEQ ID NO: 61, and a CDR3 having the amino acid sequence of SEQ ID NO: 62.
8. The method of claim 7 , wherein the disease or disorder is osteoporosis.
9. The method of claim 7 , wherein the antibody increases serum Procollagen I N-terminal Propeptide (PINP) levels in vivo, increases bone mineral density in vivo, increases midshaft femur cortical thickness in vivo, increases midshaft femur bone area in vivo, increases midshaft humerus cortical thickness in vivo, increases endocortical bone formation in vivo, increases the proportion of cortical bone volume in the LV5 vertebral body in vivo, and/or increases the proportion of femoral neck bone volume to femoral neck total volume in vivo.
10. The method of claim 7 , wherein the antibody is selected from a chimeric antibody, a humanized antibody, and a human antibody.
11. The antibody of claim 7 , wherein the heavy chain variable region comprises an amino acid sequence selected from SEQ ID NOs: 15, 23, 31, 55, 63, 71, 75, and 79.
12. The antibody of claim 7 , wherein the light chain variable region comprises an amino acid sequence selected from SEQ ID NOs: 16, 24, 32, 56, 65, 73, 77, and 81.
13. The antibody of claim 7 , wherein:
a) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 15 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 16;
b) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 71 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 73;
c) the heavy chain comprises the amino acid sequence of SEQ ID NO: 72 and the light chain comprises the amino acid sequence of SEQ ID NO: 74;
d) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 23 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 24;
e) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 75 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 77;
f) the heavy chain comprises the amino acid sequence of SEQ ID NO: 76 and the light chain comprises the amino acid sequence of SEQ ID NO: 78;
g) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 31 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 32;
h) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 79 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 81;
i) the heavy chain comprises the amino acid sequence of SEQ ID NO: 80 and the light chain comprises the amino acid sequence of SEQ ID NO: 82;
j) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 55 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 56;
k) the heavy chain variable region comprises the amino acid sequence of SEQ ID NO: 63 and the light chain variable region comprises the amino acid sequence of SEQ ID NO: 65; or
l) the heavy chain comprises the amino acid sequence of SEQ ID NO: 64 and the light chain comprises the amino acid sequence of SEQ ID NO: 66.